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Narcissistic Personality Disorder

An enduring pattern of grandiose beliefs and arrogant behavior together with an overwhelming need for admiration and a lack of empathy for (and even exploitation of) others.

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(Source: NIH - National Cancer Institute)

What works? Research summarized

Evidence reviews

The outcome of psychodynamic psychotherapies with individuals diagnosed with personality disorders: a systematic review.

Bibliographic details: Haskayne D, Hirschfeld R, Larkin M.  The outcome of psychodynamic psychotherapies with individuals diagnosed with personality disorders: a systematic review. . Psychoanalytic Psychotherapy 2014; 28(2): 115-138 Available from: http://www.tandfonline.com/doi/abs/10.1080/02668734.2014.888675

Prevalence and treatment of narcissistic personality disorder in the community: a systematic review

BACKGROUND: Few studies have examined the prevalence and treatment of narcissistic personality disorder (NPD).

Borderline Personality Disorder: Treatment and Management

The guideline on Borderline Personality Disorder, commissioned by NICE and developed by the National Collaborating Centre for Mental Health, sets out clear, evidence- and consensus-based recommendations for healthcare staff on how to treat and manage borderline personality disorder.

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Summaries for consumers

Community mental health teams for people with severe mental illnesses and disordered personality

Since the 1950s there has been a trend to close institutions of care for people who are mentally unwell. In addition, government policy has sought to reduce the number of hospital beds available in favour of care being provided in the community to enable people to live more independent lives. The aim of Community Mental Health Teams (CMHTs) is to bring a specialist care package to people in the community. We reviewed the available evidence on CMHTs compared with standard non‐team community care. We found only three trials which indicated some benefit in terms of acceptability of treatment, but overall the evidence for CMHTs is inadequate and further trials are needed to determine its effectiveness.

Drug treatment for borderline personality disorder

Many people with borderline personality disorder (BPD) receive medical treatment. However, there are no drugs available for BPD treatment specifically. A certain drug is most often chosen because of its known properties in the treatment of associated disorders, or BPD symptoms that are also known to be present in other conditions, such as depressive, psychotic, or anxious disorders. BPD itself is characterised by a pervasive pattern of instability in affect regulation (with symptoms such as inappropriate anger, chronic feelings of emptiness, and affective instability), impulse control (symptoms: self‐mutilating or suicidal behaviour, ideation, or suicidal threats to others), interpersonal problems (symptoms: frantic efforts to avoid abandonment, patterns of unstable relationships with idealization and depreciation of others), and cognitive‐perceptual problems (symptoms: identity disturbance in terms of self perception, transient paranoid thoughts or feelings of dissociation in stressful situations). This review aimed to summarise the current evidence of drug treatment effects in BPD from high‐quality randomised trials.

Antiepileptic drugs for treating recurrent aggression

Various medicines, which are collectively termed 'antiepileptic drugs', have been used to treat persistent aggression. This review systematically examines the evidence supporting this practice. From the evidence available, we were unable to draw any firm conclusion about using these medicines to treat aggression. Four antiepileptic drugs (valproate/divalproex, carbamazepine, oxcarbazepine and phenytoin) helped to reduce aggression in at least one study. However, for three of these drugs (valproate, carbamazepine and phenytoin) we found at least one other study where there was no significant improvement. Further research is needed to clarify which antiepileptic drugs are effective for whom. Such research is best carried out using carefully designed clinical trials. Such trials need to take account of the type of aggression displayed, the severity of the aggression, and any other disorders experienced by the participants.

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